Buprenorphine Patients Use Rx Opioids During and After Treatment

More than 43 percent of patients receiving buprenorphine for opioid addiction also receive prescriptions for other opioid painkillers during treatment, and 67 percent are prescribed opioids in the year after their treatment ends, finds a study from the Johns Hopkins Bloomberg School of Public Health. Study researchers reviewed prescriptions in 11 states for 38,096 new buprenorphine users between 2006 and 2013, looking at prescriptions for opioids other than buprenorphine that were filled before, during, and after a patient’s first course of buprenorphine treatment.

The researchers say their results, published Feb. 23 in the journal Addiction, demonstrate the need for more resources for medication-assisted treatment (MAT) programs. Even though MAT is considered the most effective method to treat substance abuse, 40 to 60 percent of addicts relapse, a standard rate for setbacks for people with chronic diseases.

“Policymakers may believe that people treated for opioid addiction are cured, but people with substance use disorders have a lifelong vulnerability, even if they are not actively using,” said study author G. Caleb Alexander. “Our findings highlight the importance of stable, ongoing care for these patients.”

Although opioids are sometimes prescribed after major injuries or surgery even for those with opioid use disorder, such circumstances do not explain the rates of opioid prescriptions in the study. Also, patient use of illicit opioids like heroin was not part of the study, and the researchers believe their results likely underestimate how many patients use opioids during and after buprenorphine treatment.

Currently there are no official guidelines for how long a patient should remain in treatment. Patients in this study typically stopped treatment within three months. “We need to find better ways to keep patients engaged in long-term treatment, and these efforts couldn’t be more urgent given how many Americans continue to die or get injured from opioids,” said co-author Matthew Daubresse.